Comparison between CURB-65, PSI, and SIPF scores as predictors of ICU admission and mortality in community-acquired pneumonia

Objective

To compare the prognostic value of the SIPF (shock index and hypoxemia) score as the combination of shock index (heart rate/systolic blood pressure) >0.7 (1 point) plus PaO₂/FiO₂ < 250 (1 point), and the severity score for community-acquired pneumonia (CAP) (CURB-65) and pneumonia severity index (PSI) in predicting the need for ICU admission and mortality of patients with community-acquired pneumonia.

Patients and methods

This retrospective study was conducted on patients with CAP admitted to AL-Hussein University hospital (Egypt), Muhayl general hospital and King Khalid hospital at Hail, (KSA). The information required for calculating SIPF, PSI and CURB-65 was extracted from the medical records.

Results

We studied 100 patients with community-acquired pneumonia (64 men, 36 women). Thirty-four patients needed ICU admission (while 66 did not need ICU admission and admitted in observation room or general ward) and among the ICU patients 21 cases needed mechanical ventilation. Ten cases died; 9 cases in ICU and one case in observation room (ward). The ability to predict ICU admission was higher for SIPF score compared to CURB-65 (AUC SIPF 0.88 vs. 0.83; p < 0.001) and PSI (AUC SIPF 0.88 vs. 0.79; p < 0.001). The ability to predict mortality was higher for SIPF score compared to CURB-65(AUC SIPF 0.80 vs. 0.84; p < 0.001) and PSI (AUC SIPF 0.80 vs. 0.83; p < 0.001).

Conclusion

The ability of SIPF score to predict ICU admission in CAP is higher than that of CURB-65 and PSI. Simple SIPF score could be a useful tool to predict mortality in CAP.